Abstract
FDG-PET scan imaging for sarcoma patients serves several important purposes including (1) the identification of high-grade sarcomas, which may present initially as histologically low or intermediate-grade tumors; (2) the pre-resection assessment and demonstration of tumor response following neoadjuvant systemic therapy, by serial PET imaging, in addition to concurrent, serial MRI; and (3) the assessment of metastasis or local tumor recurrence on subsequent patient restaging during the course of treatment or follow-up.
The pre-resection treatment of sarcomas via systemic “neoadjuvant” therapy, pioneered in the 1970s–1980s for pediatric osteosarcoma led to the development of adult soft tissue sarcoma neoadjuvant treatment models, in an attempt to improve tumor resectability and lower the risk of recurrent or metastatic disease. The challenges of sarcoma histologic or pathologic grading, the assessment of tumor histologic response to neoadjuvant treatment, and the subsequent planning of surgical resection margins all remain challenging patient assessments that can be improved by FDG-PET imaging, in collaboration with serial MRI. Those PET imaging techniques should improve in the future with new, alternative molecular targets that exceed the sensitivities of current FDG-PET imaging.
PET imaging for sarcoma patients provides the ability to achieve treatment assessments that are timely and equally or more accurate than current pathologic and imaging methods.
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Hayden, B.L., Amin, A., Conrad, E.U. (2021). PET in Sarcoma: Surgeons Point of View. In: Khandani, A.H. (eds) PET/CT and PET/MR in Melanoma and Sarcoma. Springer, Cham. https://doi.org/10.1007/978-3-030-60429-5_8
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